Evidence-based strategies are an important part of treatment and relapse prevention when working with diverse populations of justice-involved individuals who are affected by addiction. For example, cognitive-behavioral therapies have an evidence base supporting their use and can be integrated into treatment approaches for clients who struggle with substance abuse. Additionally, Motivational Interviewing and relapse prevention appear to be effective across many drugs of abuse. In this assignment, you will explore the chronic nature of addiction and how evidence-based strategies can be applied to relapse prevention.

Review the Angel Case Study.

Continue in your role as an intern with the substance abuse program at your correctional facility.

Review the treatment plan you created in Week 4.

You have been asked by the treatment team to assist in the preparation of a Relapse Prevention Plan Worksheet from Angel’s perspective.

Complete the Relapse Prevention Plan Worksheet from Angel’s perspective. The goal is to show a seamless transition from treatment services into long-term recovery and successful completion of supervision from the corrections system.

Write a summary for the treatment team explaining why you believe this relapse prevention plan, prepared from the client’s point of view, would be effective. Include the following in your summary:

• 3 evidence-based strategies that are evident in your relapse plan
• Provide a thorough description of each, explaining why you believe each is relevant in this case.
• 2 references supporting why each element of the plan is appropriate and would be successful for the client

Angel is a 44-year-old separated man who says that his substance dependence and his anxiety disorder both emerged in his early 20’s after joining the army.  He says that he started to drink to “feel better” at the NCO club on base when his episodes of anxiety made it hard for him to interact with his peers.  He states that his anxiety became extreme after his first deployment to Iraq. He worked as a military police officer and was often exposed to hostile fire as his group supported operations. He also states that alcohol and now cocaine were a part of his dishonorable discharge. 

His wife called police after an argument regarding his drinking. He shoved her and police arrested him and charged him with domestic violence (DV). He was required to attend DV classes as well as substance abuse treatment as part of the plea. He further has community service hours (48) and 2 years of probation.  You are conducting the intake assessment into your treatment agency. 

Angel notes that coming off the cocaine and binge drinking contribute to low mood and increased anxiety, but he has not responded well to referrals to adjunct support services, and past inpatient stays have led to only temporary abstinence. He does not have VA connected benefits and his job as a cook offers no insurance coverage.  Yet, Angel is now trying to forge a closer relationship to his adult children, and he says he is especially motivated to get a better handle on both his PTSD and his substance use because he will be a grandfather in January. Angel states he and his wife are currently separated but talk on a daily basis.  

Symptoms 

• Alcohol Use 
• Depression 
• Anxiety 
• PTSD 

Substance Abuse 

Diagnoses and Related Treatments 

PTSD

The following treatments have empirical support for individuals with?PTSD: 

• Cognitive Processing Therapy (CPT)  
• Trauma-focused Cognitive Behavioral Therapy (cf-CBT)  
• Eye Movement Desensitization and Reprocessing (EMDR)

Mixed Substance Abuse/Dependence 

The following treatments have empirical support for individuals with?Mixed Substance Abuse/Dependence: 

• Motivational Interviewing plus CBT for Mixed Substance Abuse/Dependence 
• Seeking Safety for Mixed Substance Abuse/Dependence 
• Motivational Enhancement Therapy (MET) for Substance Abuse Treatment 

Generalized Anxiety Disorder 

The following treatments have empirical support for individuals with Mixed Substance Abuse/Dependence: 

• CBT for Generalized Anxiety Disorder 
• Psychoeducation 
• Mindfulness  

Adjunct support services 

• AA, NA or other 12-Step program  
• SMART recovery  
• Peer Recovery Coaching 
• Mindfulness Recovery 
• Relapse Prevention PlanRelapse planning is a tool to help you to create a plan that will help you prepare and prevent relapse from occurring. These plans should remain fluid and be updated as goals are met and resources or situations change. Please use the Angel Case study and the treatment plan you created in week four to complete this Relapse Plan from Angel’s perspective. Please include 3 evidence-based strategies and 2 references (and the in-text citations) that support how this would be an effective plan. Goal Identification
  What would you like to continue to focus on improving? (i.e., losing weight, saving money to buy a car, finding a better job.)What encourages you?
  What outcomes of the changes motivate you? (i.e., fitting into your clothes, working out in the gym, gaining computer skills) Difficulties you might encounter…
  What difficulties might you encounter? These could be triggers that may challenge you. (i.e., going to the old neighborhood, relational break ups, losing a job)My coping skills
  These are skills and tools used to cope and maintain sobriety (i.e., calling my coach/sponsor, regularly going to meetings, mindfulness playing the tape to the end)Relapse Prevention Action Steps
  These action steps are put in place to prevent relapse from happening. (i.e., building sober support system, giving back to the community through service, attending faith-based community activities, exercising, thinking before acting.)My self-care plan
  Identify how you will grow your life by taking care of your mind, body and spirit. (I.e., acquire new skills, chair a meeting, stretch, attend workshops, gain faith-based or spiritual insight)Sober people who support me
  Who are the sober people who support you, are your cheer leaders and want you to succeed? (i.e., parents, spouse, siblings, sponsor/coach, pastor.)I will stay accountable by these consequences
  If I have a lapse or don’t meet my goal, I must keep myself accountable. (i.e., I will fine myself $10.00 a day, I will volunteer for additional service to my community, 1 hour for every day I was short of my goal.)I am grateful for
  Daily expression of the things in life we are grateful for reminds us of how far we have come and who has helped us along the way.